The American Pain Foundation

Information. Advocacy. Support.



Date: January, 2004

To: Friends of APF

Re: HR 1863, National Pain Care Policy Act of 2003

Last year, Congressman Mike Rogers (R-MI) introduced H.R. 1863, the National Pain Care Policy Act of 2003 in the House of Representatives. The bill is an exceptional step toward gaining federal recognition of the importance of pain as a critical and unanswered health care problem in our nation.

The National Pain Care Policy Act (H.R. 1863) would create a National Center for Pain and Palliative Care Research at the National Institutes of Health (NIH) as part of a campaign to raise public awareness about pain and palliative care, which supports the medical, emotional, social and spiritual needs of people facing the end of life. The bill also includes funds to improve pain treatment and would allocate more resources for pain research.

The Pain Care Policy Act would also create a White House Conference on Pain Care to identify key barriers as part of a national campaign to provide public information regarding responsible pain management, related symptoms and palliative care.

In addition, the bill would require NIH to establish programs that develop and advance the quality, appropriateness and effectiveness of pain and palliative care and authorize the Health and Human Services Secretary to award grants, cooperative agreements and public/private contracts to further the education and training of health care professionals in those areas.

Your support is needed! Please write to your Members of Congress to request her/his support as a cosponsor for H.R. 1863. Click below to see the full text of the bill, a summary of the bill, talking points on pain. A sample letter and other resources are included (click on Take Action! below).

Thank you for joining us in the fight for good pain care!

 Updated January, 2004

© 2003 American Pain Foundation
201 N. Charles Street, Suite 710, Baltimore, Maryland 21201-4111


Section 1: Short Title

Provides that the title of the bill shall be the "National Pain Care Policy Act of 2003."

Section 2: White House Conference on Pain Care

Authorizes a White House Conference on Pain Care. The purposes of the conference would be to:

 Section 3: National Center for Pain and Palliative Care Research

Establishes a National Center for Pain and Palliative Care Research at the National Institutes of Health. Primary functions of the Center would include:

Section 4: Pain Care Education and Training

Requires the Agency for Healthcare Research and Quality (AHRQ) to: 

Section 5: Public Awareness Campaign on Pain Management

Requires the Secretary of DHHS to develop and implement a national outreach and awareness campaign to educate consumers, patients, families and other caregivers on:

Section 6: Pain Care Initiative in Military Health Facilities

Requires the Secretary of Defense to develop and implement a pain care initiative in all military health care facilities to ensure that all personnel receiving treatment in military health care facilities are assessed for pain at the time of admission or initial treatment, and that they receive appropriate pain care.

Section 7: Pain Care Standards in Medicare+Choice Plans

Requires managed health care plans that offer Medicare+Choice plans to older persons to offer appropriate care for the treatment of patients in pain, including specialty and tertiary care for patients with intractable pain.

Section 8: Pain Care Standards in TRICARE Plans

Requires similar protections for military personnel and dependents enrolled in TRICARE plans.

Section 9: Annual Report on Medicare Expenditures for Pain Care Services

Requires CMS to submit to Congress an annual report on Medicare expenditures for pain and palliative care.

Section 10: Pain Care Initiative in Veterans Health Care Facilities

Requires the Secretary of the VA to develop and implement a pain care initiative in all VA health care facilities to ensure that all veterans receiving treatment in those facilities are assessed for pain at the time of admission or initial treatment, and that they receive appropriate pain care.



Magnitude of the Pain Problem

Over 75 million Americans suffer serious pain annually: 50 million of those endure serious chronic pain annually (pain lasting 6 months or more), and another 25 million experience acute pain (from injuries, accidents, surgeries, etc.). [National Pain Survey, conducted for Ortho-McNeil Pharmaceutical, 1999]

Headache, lower back pain, arthritis and other joint pain, and peripheral neuropathy are the most common forms of chronic pain. ["Pain in America," study sponsored by Mayday Fund, 1998]

Over 26 million adults experience frequent back pain and 2/3 of Americans will have back pain during their lifetime. [Dionne, C.E., "Low back pain," Epidemiology of Pain, (Seattle:IASP) 1999.]

1 in 6 Americans suffers from arthritis. [Lawrence, R.C., et al, "Estimates of the Prevalence of Arthritis and Selected Musculos-Skeletal Disorders in the United States," Arthritis and Rheumatism, 1998.]

Close to 4 million Americans -- mostly women -- suffer from fibromyalgia, a complex condition involving widespread pain and other symptoms.

The Gross Undertreatment of Pain in America

A 1999 study, Chronic Pain in America, found that only 1 in 4 of those with pain received adequate treatment. ["Chronic Pain in America," survey conducted for American Pain Society, American Academy of Pain Medicine and Janssen Pharmaceutica, 1999.]

An estimated 70% of those with cancer experience significant pain during their illness, yet in an early study of cancer pain fewer than half received adequate treatment for their pain. [Grossman, S., et al, "Correlation of patient and caregiver ratings of cancer pain," Journal of Pain and Symptom Management, 1991; and Von Roenn, et al, "Physician Attitude and Practice in Cancer Pain Management," Annals of Internal Medicine, 15 July 1993 (119:2).

A recent study published in the Journal of the American Medical Association (JAMA) of nursing home patients with cancer found that 24% of patients with significant pain received nothing stronger than aspirin.

Another study recently published in JAMA found that 41% of nursing home patients who were admitted with moderate to severe pain still had approximately the same level of pain 6 months later.

The Cost of Pain to Society

The National Institute of Health estimates that pain costs us over $100 billion/year in medical expenses, lost wages and other costs. [National Institute of Health, The NIH guide: New directions in pain research I, Washington, DC:GPO, 1998.]

A study found that 50 million workdays were lost to pain in 1995. ["Pain and absenteeism in the workplace," study conducted for Ortho-McNeil Pharmaceutical, 1997.] The same study revealed that untreated pain results in lower productivity, greater employee absenteeism, and higher insurance premiums.


Please click here to send a letter through Last Act Partnership's Action Alert Campaign or

Modify the letter below as needed (please include a story about yourself or someone you know with pain) and send it to your elected representatives.

To find your elected officials and their contact information, please visit




The Honorable (full name)
U. S. House of Representatives
Washington DC 20515

Dear Representative (last name): 

            (Start with a personal introduction and story about how pain has affected your life or the life of a loved one……“I am a person suffering with chronic pain…….”)

            I am writing to urge your support and co-sponsorship of H.R.1863, the National Pain Care Policy Act. This bill, introduced by Rep. Mike Rogers of Michigan is the first comprehensive pain care bill ever introduced in the Congress.  The American Pain Foundation, Pain Care Coalition, American Medical Association and others enthusiastically support this bill.

            Pain is one of the nation’s greatest healthcare problems.  Millions of Americans suffer with serious chronic pain that affects almost every aspect of their lives. Yet, few pain sufferers get the care they need and deserve. Unfortunately, our federal government does little to ensure access to effective pain care, or to promote pain research and pain management education for healthcare professionals.

            Please help me and the millions of Americans like me who suffer in pain by co-sponsoring H.R.1863 and working for its passage.

                                                                                    Your name